8 results on '"Nair, Gonasagrie"'
Search Results
2. Social harms in female-initiated HIV prevention method research: state of the evidence.
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Montgomery, Elizabeth T, Roberts, Sarah T, Nel, Annalene, Malherbe, Mariette, Torjesen, Kristine, Bunge, Katherine, Singh, Devika, Baeten, Jared M, Marrazzo, Jeanne, Chirenje, Z Mike, Kabwigu, Samuel, Beigi, Richard, Riddler, Sharon A, Gaffour, Zakir, Reddy, Krishnaveni, Mansoor, Leila E, Nair, Gonasagrie, Woeber, Kusbashni, Moodley, Jayajothi, Jeenarain, Nitesha, Siva, Samantha, Naidoo, Logashvari, Govender, Vaneshree, and Palanee-Phillips, Thesla
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Biomedical and Clinical Sciences ,Health Services and Systems ,Public Health ,Health Sciences ,Clinical Sciences ,Topical Microbicides ,Behavioral and Social Science ,HIV/AIDS ,Prevention ,Clinical Research ,Infectious Diseases ,Mental Health ,Patient Safety ,Clinical Trials and Supportive Activities ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Infection ,Good Health and Well Being ,Africa South of the Sahara ,Anti-HIV Agents ,Double-Blind Method ,Ethics ,Research ,Female ,HIV Infections ,Humans ,Intimate Partner Violence ,Male ,Patient Participation ,Prospective Studies ,Safety ,Vaginal Creams ,Foams ,and Jellies ,Africa ,HIV ,microbicide ,social harms ,women ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectivesAssessment of safety is an integral part of real-time monitoring in clinical trials. In HIV prevention research, safety of investigational products and trial participation has been expanded to include monitoring for 'social harms', generally defined as negative consequences of trial participation that may manifest in social, psychological, or physical ways. Further research on social harms within HIV prevention research is needed to understand the potential safety risks for women and advance the implementation of prevention methods in real-world contexts.MethodsSecondary analysis of quantitative data from three randomized, double-blind, placebo-controlled trials of microbicide candidates in sub-Saharan Africa was conducted. Additionally, we assessed data from two prospective cohort studies that included participants who became HIV-positive or pregnant during parent trials.ResultsSocial harms reporting was low across the largest and most recent microbicide studies. Social harm incidence per 100 person-years ranged from 1.10 (95% CI 0.78-1.52) to 3.25 (95% CI 2.83-3.74) in the phased trials. Reporting differed by dosing mechanism (e.g. vaginal gel, oral tablet, ring) and study, most likely as a function of measurement differences. Social harms were most frequently associated with male partners, rather than, for example, experiences of stigma in the community.ConclusionMeasurement and screening for social harms is an important component of conducting ethical research of novel HIV prevention methods. To date, social harm incidence reported in microbicide trials has been relatively low (
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- 2019
3. Complex decisions: correlates of injectable contraceptive discontinuation following HIV-1 seroconversion in an HIV prevention trial
- Author
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Caplan, Margaret R, Landovitz, Raphael J, Palanee-Phillips, Thesla, Nair, Gonasagrie, Mhlanga, Felix, Balkus, Jennifer E, Riddler, Sharon A, and Gorbach, Pamina M
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Public Health ,Health Sciences ,HIV/AIDS ,Behavioral and Social Science ,Clinical Research ,Contraception/Reproduction ,Infectious Diseases ,Prevention ,Reproductive health and childbirth ,Infection ,Good Health and Well Being ,Adult ,Contraception ,Contraception Behavior ,Contraceptive Agents ,Female ,Family Planning Services ,Female ,HIV Infections ,HIV Seropositivity ,HIV-1 ,Humans ,Incidence ,Infectious Disease Transmission ,Vertical ,Injections ,Pregnancy ,Seroconversion ,South Africa ,Uganda ,Zimbabwe ,Injectable ,female contraception ,HIV infection ,Africa ,seroconversion ,Public Health and Health Services ,Psychology ,Public health ,Sociology ,Clinical and health psychology - Abstract
Contraceptive adherence during acute and recent HIV-1 infection is important to maternal and child health given the elevated risk of vertical HIV-1 transmission and additional complications of pregnancy. Injectable contraception (IC) is the most common non-barrier modern contraception method used in sub-Saharan Africa (SSA). Adherence to IC after HIV-1 seroconversion is not well understood. We examined factors associated with IC discontinuation among women in SSA diagnosed with HIV-1 infection while participating in a clinical trial of biomedical HIV-1 prevention. After diagnosis with HIV-1 infection in the VOICE trial, 255 women from South Africa, Uganda, and Zimbabwe enrolled in a longitudinal observational study (MTN-015). Contraceptive method was assessed at MTN-015 baseline and at 3, 12, and 24 months post-seroconversion. Correlates of IC discontinuation were examined by Cox proportional hazard modeling. IC use was reported at baseline by 78% of women enrolled (198/255), of which 92% (182/198) completed at least one follow-up visit. Two-thirds of women (66%, 121/182) continued on IC during the follow-up period (median 24 months). Lower rates of IC discontinuation were observed in women who reported having had at least one child (HR 0.39, 95% CI 0.20-0.82) or earning a personal income (HR 0.51, 95% CI 0.30-0.87) at baseline. These findings suggest that many women with HIV-1 infection face complex decision-making regarding family planning in the years that follow seroconversion and highlight that some women may discontinue IC use despite on-site provision of family planning services. Understanding the broader context of family planning choices in recently seroconverted women may be key to more effective linkages between family planning services and HIV-1 testing and care.
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- 2019
4. Use of a Vaginal Ring Containing Dapivirine for HIV-1 Prevention in Women
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Baeten, Jared M, Palanee-Phillips, Thesla, Brown, Elizabeth R, Schwartz, Katie, Soto-Torres, Lydia E, Govender, Vaneshree, Mgodi, Nyaradzo M, Matovu Kiweewa, Flavia, Nair, Gonasagrie, Mhlanga, Felix, Siva, Samantha, Bekker, Linda-Gail, Jeenarain, Nitesha, Gaffoor, Zakir, Martinson, Francis, Makanani, Bonus, Pather, Arendevi, Naidoo, Logashvari, Husnik, Marla, Richardson, Barbra A, Parikh, Urvi M, Mellors, John W, Marzinke, Mark A, Hendrix, Craig W, van der Straten, Ariane, Ramjee, Gita, Chirenje, Zvavahera M, Nakabiito, Clemensia, Taha, Taha E, Jones, Judith, Mayo, Ashley, Scheckter, Rachel, Berthiaume, Jennifer, Livant, Edward, Jacobson, Cindy, Ndase, Patrick, White, Rhonda, Patterson, Karen, Germuga, Donna, Galaska, Beth, Bunge, Katherine, Singh, Devika, Szydlo, Daniel W, Montgomery, Elizabeth T, Mensch, Barbara S, Torjesen, Kristine, Grossman, Cynthia I, Chakhtoura, Nahida, Nel, Annalene, Rosenberg, Zeda, McGowan, Ian, and Hillier, Sharon
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Reproductive Medicine ,Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Pediatric ,HIV/AIDS ,Clinical Trials and Supportive Activities ,Infectious Diseases ,Prevention ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Reproductive health and childbirth ,Infection ,Adolescent ,Adult ,Africa ,Southern ,Age Factors ,Double-Blind Method ,Drug Resistance ,Viral ,Female ,HIV Infections ,HIV-1 ,Humans ,Incidence ,Middle Aged ,Patient Compliance ,Pyrimidines ,Reverse Transcriptase Inhibitors ,Vagina ,Young Adult ,MTN-020–ASPIRE Study Team ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundAntiretroviral medications that are used as prophylaxis can prevent acquisition of human immunodeficiency virus type 1 (HIV-1) infection. However, in clinical trials among African women, the incidence of HIV-1 infection was not reduced, probably because of low adherence. Longer-acting methods of drug delivery, such as vaginal rings, may simplify use of antiretroviral medications and provide HIV-1 protection.MethodsWe conducted a phase 3, randomized, double-blind, placebo-controlled trial of a monthly vaginal ring containing dapivirine, a non-nucleoside HIV-1 reverse-transcriptase inhibitor, involving women between the ages of 18 and 45 years in Malawi, South Africa, Uganda, and Zimbabwe.ResultsAmong the 2629 women who were enrolled, 168 HIV-1 infections occurred: 71 in the dapivirine group and 97 in the placebo group (incidence, 3.3 and 4.5 per 100 person-years, respectively). The incidence of HIV-1 infection in the dapivirine group was lower by 27% (95% confidence interval [CI], 1 to 46; P=0.046) than that in the placebo group. In an analysis that excluded data from two sites that had reduced rates of retention and adherence, the incidence of HIV-1 infection in the dapivirine group was lower by 37% (95% CI, 12 to 56; P=0.007) than that in the placebo group. In a post hoc analysis, higher rates of HIV-1 protection were observed among women over the age of 21 years (56%; 95% CI, 31 to 71; P
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- 2016
5. An Empiric HIV Risk Scoring Tool to Predict HIV-1 Acquisition in African Women
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Balkus, Jennifer E, Brown, Elizabeth, Palanee, Thesla, Nair, Gonasagrie, Gafoor, Zakir, Zhang, Jingyang, Richardson, Barbra A, Chirenje, Zvavahera M, Marrazzo, Jeanne M, and Baeten, Jared M
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Public Health ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Infectious Diseases ,HIV/AIDS ,Clinical Research ,Prevention ,Behavioral and Social Science ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Infection ,Good Health and Well Being ,Adult ,Africa ,Empirical Research ,Female ,HIV Infections ,HIV-1 ,Humans ,Incidence ,Male ,Predictive Value of Tests ,Randomized Controlled Trials as Topic ,Risk Assessment ,Risk Factors ,Sexual Partners ,HIV-1 acquisition ,African women ,clinical prediction rules ,AIDS ,risk score ,Public Health and Health Services ,Virology ,Clinical sciences ,Epidemiology ,Public health - Abstract
ObjectiveTo develop and validate an HIV risk assessment tool to predict HIV acquisition among African women.DesignData were analyzed from 3 randomized trials of biomedical HIV prevention interventions among African women (VOICE, HPTN 035, and FEM-PrEP).MethodsWe implemented standard methods for the development of clinical prediction rules to generate a risk-scoring tool to predict HIV acquisition over the course of 1 year. Performance of the score was assessed through internal and external validations.ResultsThe final risk score resulting from multivariable modeling included age, married/living with a partner, partner provides financial or material support, partner has other partners, alcohol use, detection of a curable sexually transmitted infection, and herpes simplex virus 2 serostatus. Point values for each factor ranged from 0 to 2, with a maximum possible total score of 11. Scores ≥5 were associated with HIV incidence >5 per 100 person-years and identified 91% of incident HIV infections from among only 64% of women. The area under the curve (AUC) for predictive ability of the score was 0.71 (95% confidence interval [CI]: 0.68 to 0.74), indicating good predictive ability. Risk score performance was generally similar with internal cross-validation (AUC = 0.69; 95% CI: 0.66 to 0.73) and external validation in HPTN 035 (AUC = 0.70; 95% CI: 0.65 to 0.75) and FEM-PrEP (AUC = 0.58; 95% CI: 0.51 to 0.65).ConclusionsA discrete set of characteristics that can be easily assessed in clinical and research settings was predictive of HIV acquisition over 1 year. The use of a validated risk score could improve efficiency of recruitment into HIV prevention research and inform scale-up of HIV prevention strategies in women at highest risk.
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- 2016
6. The role of an ethics advisory committee in data science research in sub-Saharan Africa.
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Kling, Sharon, Singh, Shenuka, Burgess, Theresa L., and Nair, Gonasagrie
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The article focuses on the ethical implications of data science research, particularly in the context of big data and its use in healthcare. Topics discussed include the need for ethics review in data science research, challenges related to bias and privacy, the establishment of ethics advisory committees, and suggested reforms to improve the ethics review process.
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- 2023
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7. Feasibility, Performance, and Acceptability of the Wisebag™ for Potential Monitoring of Daily Gel Applicator Use in Durban, South Africa
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van der Straten, Ariane, Montgomery, Elizabeth, Pillay, Diantha, Cheng, Helen, Naidoo, Anushka, Cele, Zakhele, Naidoo, Kalendri, Hartmann, Miriam, Piper, Jeanna, and Nair, Gonasagrie
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- 2013
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8. Feasibility, Performance, and Acceptability of the Wisebag™ for Potential Monitoring of Daily Gel Applicator Use in Durban, South Africa.
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Straten, Ariane, Montgomery, Elizabeth, Pillay, Diantha, Cheng, Helen, Naidoo, Anushka, Cele, Zakhele, Naidoo, Kalendri, Hartmann, Miriam, Piper, Jeanna, and Nair, Gonasagrie
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ANTI-infective agents ,STATISTICAL correlation ,PHARMACEUTICAL gels ,RESEARCH funding ,PILOT projects ,EQUIPMENT & supplies ,RANDOMIZED controlled trials ,BLIND experiment ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
The Wisebag™, a lunchbag-style container with an electronic events-monitoring system, was designed as a real-time indirect objective measure of microbicide gel use. Due to cost, alternative functionalities (i.e. use of offline and dummy versions) were explored. We conducted a three-arm, double-blinded pilot study among 50 HIV-negative women in Durban, South Africa to assess participant adherence and Wisebag acceptability and performance. Participants were randomized 2:2:1 to Wisebag with online (events transmitted via cellular signal in real-time), offline (events stored in device memory) or inactive 'dummy' devices. Participants were instructed to open the Wisebag daily for 2 weeks, retrieve a study sticker and affix it on a diary card. All participants completed the study. At exit, 94 % did not know which device they had received, nor could they differentiate the Wisebag types when presented with the three options. Five offline devices failed (no data recorded). Per Wisebag events, 26 % of women were perfectly adherent compared to 48 % by self-report and 46 % per diary card. Of reported non-adherence, 92 % did not open the Wisebag (travelling or forgot) and 22 % opened Wisebag >1×/day (curiosity). Participants liked and were comfortable carrying Wisebag. Successful blinding will allow inclusion of offline and/or dummy Wisebags in future study designs. Perfect adherence by opening events was significantly lower than by self-report, highlighting the importance of objective measures of adherence in clinical trials. Additional studies to validate Wisebag data with actual products, with and without SMS and online functionality, in different populations and settings, and in comparison to biomarkers are warranted. [ABSTRACT FROM AUTHOR]
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- 2013
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